Abstract TMP76: Outcomes in Large Mostly Intraventricular Hemorrhage: From the Clear III Trial Public Use Dataset

Abstract

Introduction: Intraventricular hemorrhage (IVH), a common complication of intracerebral hemorrhage (ICH), can occur with little or no associated ICH (mostly IVH, mIVH). mIVH is reported to have better outcomes than IVH associated with substantial ICH. Few data exist describing outcomes from mIVH, especially more severe cases. Hypothesis: Using the CLEAR III public use dataset, outcomes from large mIVH can be described and may be useful to providers and families making decisions about goals of care. Methods: Large mIVH was defined as CLEAR III patients with ICH volume < 5 cc and IVH volume > 30 cc. A backward stepwise logistic regression model identified baseline predictors of 180 day modified Rankin score 0-3 (good outcome), and a post-estimation probability was calculated for each patient. Descriptive nonparametric statistics are provided, including medians with interquartile range (IQR). Patients were divided into prognostic tertiles based on probability of a good outcome with corresponding 180 day modified Rankin scores (mRS) are displayed via a Sankey diagram. Results: Overall, 72/500 (14.4%) of CLEAR III patients had large mIVH. Among these 72, median (IQR) age was 59.5 (51-68) years, 39% were female, median (IQR) GCS 8 (6.5-10), IVH volume 48 cc (39-67) and 180 day mRS 4 (2-6). Age and IVH volume were final model independent predictors of good outcome. Baseline median (IQR) values for Age and IVH volume in each prognostic tertile with 180 day mRS distributions are shown in the Figure. Good outcome was possible despite large mIVH, especially with younger age and smaller IVH volumes. Conclusion: Focusing on the CLEAR III subset of patients with large mIVH, a simple regression model identified prognostic tertiles which combined with a Sankey diagram provide easily interpretable outcome distributions that may facilitate clinical decision-making.